Objective To investigate the risk fairs and significance of late recurrence in non-small cell lung cancer (NSCLC)patients who had undergone complete resection and remained recurrence-free for5 years.Methods 496 individuals diagnosed and surgically treated for Stage Ⅰ and Ⅱ A NSCLC were included.We examined patients at 3-month intervals for the first 2 years after surgery and typically at 6-month intervals thereafter on an outpatient basis.The follow-up evaluation included physical examination,inaging examination and tumor narkers.Pathological examination had also been performed when needed.Of these,336 patients remained recurrence-free for 5 years were followed up continuously for 3 years.Clinicopathologic factors were collected including age,sex,smoking history,preoperative serum carcinoembryonic antigen (CEA) level,surgical apprach,maximum tumor dimension on resected specimen,histologic type,histologic differentiation,intratumoral lymphatic permeation,intratumoral vascular invasion,pleural invasion and pathologic stage.The primary end event was lung cancer recurrence.The data collection ended in January 2011.Kaplan-Meier method was used for survival rate.Survival difference wasevaluated bylog-rank test.Multivariate Cox regression was used to test the relationship of recurrence-free probability to various clinicopathologic factors.Results At 5 years after resection,109 patients had died of disease and 33 had died of other causes.18 patients were alive with disease.The remaining 3 - 36 patients were alive and recurrence-free for the first 5 years.The median follow-up period of these 5-year recurrence free survivors was 27 months (range,3-36 months).34 (10.1％)patients developed a late recurrence at 3 years among the 336 patients.Recurrence was locoregional in 13 (38.2％)patients:6 patients in mediastinal lymph nodes,3 patients in ipsilateral lung,2 patients with pleural dissemination and 2 patients in other locations.Recurrence was distant in 21 (61.8％) patients:8 patients with multiple-organ metastases,13 patients with single-organ metastasis,and the latter consisted of 5 patients in contralateral lung,3 patients in liver,2 patients in central nervous system and 3 patients in other locations.Smoking history,preoperative serum CEA level,histologic differentiation,intratumoral lymphatic invasion,intratumoral vascular invasion,pleural invasion and pathologic stage were risk factors for late recurrence in univariate analysis.Multivariate Cox analysis demonstrated that intratumoral vascular invasion and intratumoral lymphatic invasion were independent risk factors for late recurrence.Conclusion NSCLC patients have a significant risk of late recurrence after complete resection 5 years,especially for the patients with intratumoral vascular invasion and intralumoral lymphatic invasion.It is needed and significant for the patients to follow up continuously after 5 years of complete resection.

Objective The chemical components of lyophilized powder of Sinisan were analyzed by the method of RP-HPLC.Methods HPLC Method was applied for quality assessment on lyophilized powder of Sinisan.Column: Kromasil C18 column(250 mm ? 4.6 mm,5 ?m);wavelength: 210 and 240 nm;flow-rate: 1.0 mL/min;column temperature: 28 ℃.Mobile phase: acetonitrile(A) and H2O(acidified to pH=3 with phosphoric acid)(B).Concentration of lyophilized powder of Sinisan was resolved into different parts and analyzed by the same method,the variation of the chemical components was analyzed.Results At 240 nm,21 peaks were detected and two of them were confirmed to be from Bupleurum chinense,three from Paeonla lactiflora,ten from Citrus aurantium,and five from Glycyrrhiza uralensis.At 210 nm,24 peaks were detected and one of them was confirmed to be from B.chinense,four from P.lactiflora,fourteen from C.aurantium,and five form G.uralensis.Conclusion This method can be used to establish the fingerprint chromatograph of lyophilized powder of Sinisan and elucidate the variation of chemical components completely.

Objective To observe the dynamic changes of TNF-α,IL-1β,IL-6,IL-10,and expressions of Notch-1,NF-κB mRNA and their protein levels in the brain tissue of septic mice and intervention effects of intrathecal injection of lentiviral vector of miR-34a gene for regulating Notch-1/NF-κB signaling pathway.Methods A total of 54 mice of clean grade were divided randomly (random number) into four groups,namely sham group (n =9),in which sham-operated laparotomy was performed;CLP group (n=15),in which the cecum ligation operation (CLP) was performed;NC group (n =15),in which intrathecal injection of lentivirus 5 μL (concentration 5 × 108 TU/mL),one time per day,for 3 days,then CLP was performed on the seventh day;intervention group (n =15),in wihch intrathecal injection of miR-34a lentivirus 5 μL (concentration 5 × 108 TU/mL),one time per day,for 3 days,then CLP was performed on the seventh day.The mice of four groups were sacrificed 24 h after modeling or operation.The changes of behavior of mice was observed and the neurological scores were assessed 24 h after CLP.The levels of TNF-α,IL-1β,IL-6 and IL-10 in the brain were measured by ELISA method.The mRNA expression and protein levels of Notch-1 and NF-κB in the brain tissue were measured by real-time PCR and Western blot method,respectively.Pathological changes of brain tissue were observed under light microscope.Results The neurological scores,the cerebral TNF-α,IL-6 levels,the mRNA expression and protein level of NF-κB (P＜0.01),and IL-1β levels (P ＜0.05) in CLP group 24 h after modeling were higher than those in sham group.The cerebral IL-10 level and the mRNA expression and protein level of Notch-1 (P ＜ 0.01) in CLP group 24 h after modeling were lower than those in sham group.The neurological scores,the cerebral TNF-α and IL-1β levels,and the protein level of NF-κB (P ＜0.01),and IL-6 (P ＜ 0.05) in NC group 24 h after modeling were higher than those in sham group.The cerebral IL-10 level,the mRNA expression and protein level of Notch1 in NC group 24 h after modeling were lower than those in sham group.There were no significant difference in neurological socres,IL-1β and IL-6 levels between intervention group and CLP group (P ＞ 0.05).The IL-10 level (P ＜ 0.05) and the mRNA expression (P ＜ 0.05) and protein level (P ＜ 0.01) of Notch-1 in intervention group 24 h after modeling were lower than those in CLP group.There were no significant difference in biomarkers between NC group and CLP group (P ＞ 0.05).The degree of cerebral damage found under light microscope was also ameliorated in intervention group compared with CLP group 24 h after modeling.Conclusions The effects of miR-34a via regulating Notch-1/NF-κB signaling pathway on brain function exerts cerebral protective effects in septic mice.

Objective To evaluate nutritional status during hospitalization of very low birth weight infant (VLBWI) and to analyze the risk factors for extrauterine growth retardation (EUGR) at discharge.Methods VLBWIs in neonatal intensive care unit (NICU),＜12 hours after birth on admission and length of hospital stay over 14 days from January 10,2007 to October 1,2011,were retrospectively studied.Relevant information,including perinatal data,weekly nutrition supplements and weight gain,and neonatal complications were collected.Data were analyzed by Chi-square test,t-test and multivariate Logistic regression analysis.Results In all 256 VLBWIs recruited,61 (23.8％) were small for gestational age at birth.One hundred and seventy-two cases,who were EUGR by weight at discharge,were divided into EUGR group.While the other 84cases were divided into non-EUGR group.The mean gestational age and mean birth weight of EUGR infants were (29.3± 1.2) weeks and (1 240± 170) g,among them,53.5％ (92/172) were extreme EUGR.Univariate analysis showed that the total energy intake [(84.9±20.9) kcal/(kg · d)],protein intake [(2.6±0.5) g/(kg · d)] and proportion ofenteral nutrition [(26.1 ± 15.3) ％] on day 7 of EUGR infants were lower than those ofnon-EUGR ones [(92.4±20.2) kcal/(kg · d),(2.8±0.5) g/(kg · d) and (30.2± 13.2) ％,respectively,t=-2.71,P=0.007; t=-2.19,P=0.030; t=-2.10,P=0.037].The enteral nutrition at the time to regain birth weight in EUGR group was lower than those in non-EUGR group [(36.4±21.6) kcal/(kg · d)vs (44.2±24.1) kcal/(kg · d),t=-2.58,P=0.011],the average growth rate after regaining birth weight and enteral nutrition proportion on day 14 were lower [(15.5±4.1) g/(kg · d) vs (17.3±3.3) g/(kg · d),(44.6± 16.6) ％ vs (49.5± 14.4) ％,respectively; t=-3.61,P=0.000; t=-2.42,P=0.016].The duration of parenteral nutrition in EUGR infants was longer than that in the non-EUGR infants [(39.6± 13.8) d vs (34.1 ±8.6) d,t=3.94,P=0.000].Multivariable logistic regression showed that small for gestational age at birth,low protein intake and low enteral nutrition proportion on day 7,low rate of weight gain after regaining birth weight were associated with EUGR on discharge,and small for gestational age at birth was the leading risk factor (OR=42.66,95％CI:9.09-200.23).Conclusions The incidence of EUGR among VLBWIs is high on discharge.Enhancing perinatal health care and early rational nutrition support are critical to reduce the incidence of EUGR and improve the neuro-developmental prognosis of these babies.

Objective To evaluate the therapeutic effect of hepatocyte growth factor(HGF) gene modified placenta-derived mesenchymal stem cells( PMSCs) on limb ischemia in a rabbit model.Methods The placental tissue was digested with enzyme, cultured and passaged.The PMSCs were characterized by surface marker expression.These cells were infected with adenoviral( Ad)-HGF and intramuscular injected for treatment of limb ischemia in a rabbit model.The blood supply of the limb was detected by digital subtraction angiography ( DSA ) and the vessel number was evaluated in histopathological HE staining.Results The results showed that Ad-HGF gene transduction increased the vascular endothelial growth factor ( VEGF ) , basic fibroblast growth factor, bFGF ( bFGF ) and HGF expression in PMSCs. Transplantation of HGF-transduced PMSCs resulted in the increase in vessel density and improvement of blood supply in the rabbit limb ischemia model.Conclusion The therapeutic effect of HGF gene engineered PMSCs on ischemia by enhancing angiogenesis in a rabbit model is evaluated.Transplantation of PMSCs with HGF gene therapy may be a promising strategy for the treatment of ischemia diseases.

Objective To build a method to simultaneously determine paeoniflorin, naringin, hesperidin, glycyrrhizic acid in Sinisan by HPLC, provide a reliable method for evaluation and effective quality control, and lay the foundation of material basis for efficacy research for TCM compound Sinisan.Methods The column was Kromasil C18 (4.6 mm×250 mm, 5μm);mobile phase was acetonitrile-0.05% phosphoric acid aqueous solution with gradient elution program;the flow rate was 1.0 mL/min;UV detection was performed at 240 nm;the detector drift tube temperature was set at 30℃.Results The linear ranges of paeoniflorin, naringin, hesperidin and glycyrrhizic acid were 0.00225-0.01125μg (r=0.999 7), 0.00390-0.00195μg (r=0.9997), 0.00198-0.00099μg (r=0.999 5), 0.00262-0.00131μg (r=0.999 7), respectively. The average recoveries of paeoniflorin, hesperidin, naringin and glycyrrhizic acid were 97.72% (RSD=1.02%), 98.45% (RSD=1.52%), 97.74% (RSD=1.63%), 98.34% (RSD=1.78%), respectively.Conclusion The method is accurate, simple, reliable and duplicable, and is available for the quality control of Sinisan.

OBJECTIVE:To optimize the ultrasonic extraction technology of salidroside in Rhodiola rosea. METHODS:With the content of salidroside as the index,L16(45)orthogonal test was designed to observe the effects of 4 factors including the mass fraction of ethanol,solid-liquid ratio,extraction time and ultrasonic power on the content of salidroside in R. rosea extraction solu-tion. By using Matlab 6.5 software,mathematical simulation of ultrasonic extraction process of salidroside was made with the data of orthogonal test. Multiple regression analysis method was adopted to optimize the ultrasonic extraction technology of salidroside, and then the extraction result of optimal technology and that of traditional heating reflux technology were compared. RESULTS:The optimal extraction technology of salidroside was as follows as ethanol mass fraction of 77%,solid-liquid ratio of 1∶34 (g∶ml),extraction time of 34 min,ultrasonic power of 237 W(ultrasonic frequency of 40 kHz). Under the above-mentioned condi-tions,the content of salidroside was up to 0.982 4%,close to the predicted value of 0.989 4%. Compared to heating reflux meth-od,the ultrasonic method has similar content of salidroside but extraction time was shortened by 62.2%. CONCLUSIONS:The ul-trasonic extraction method for extracting the salidroside in R. rosea is simple,requires shorter time,and giving rise to higher extrac-tion rate.

Objective To assess the clinical therapeutic effects and safety of Jiangtang Shuxin decoction (JTSXD) on diabetic patients complicated with chronic heart failure (CHF),and to search for its possible function mechanisms.Methods A prospective randomized controlled study was conducted,80 diabetic patients complicated with CHF [New York Heart Association (NYHA) functional class Ⅱ-Ⅲ] admitted into the Department of Traditional Chinese Medicine (TCM) or of Cardiology in Affiliated Hospital of Guangxi Youjiang National Medical College from October 2015 to September 2016 were enrolled,they were assigned to an observation group and a control group by randomized method with a computer,and finally 77 patients (39 cases in observation group and 38 cases in control group) completed this trial.The patients in control group received standardized routine western medical treatment,while the observation group was additionally administered JTSXD (including ingredients:astragalus 15 g,ginseng 10 g,radix ophiopogonis 15 g,radix rehmanniae 15 g,comus 10 g,rhizome coptidis 8 g,peach kernel 10 g,salvia mitiorrhiza 10 g,magnoliaceae 10 g,yam 15 g) on the basis of conventional therapy.The therapeutic course for all the patients in both groups was 2 months.Before and after treatment,the 6-minute walking distance (6MWD) was assessed;the TCM syndrome accumulated scores of the two groups were calculated;the left ventricular end-diastolic volume (LVEDV),the left ventricle ejection fraction (LVEF),the stroke volume (SV),the cardiac output (CO),and the maximum blood flow velocity of early diastolic/atrium late diastolic (E/A) were detected by echocardiography.The serum levels of glycosylated hemoglobin (HbA1c),angiotensin Ⅱ (Ang Ⅱ) and plasma B type brain natriuretic peptide (BNP) were tested with enzyme linked immunosorbent assay (ELISA);the level changes of total cholesterol (TC),triglyeride (TG),high density lipoprotein cholesteral (HDL-C) and low density lipoprotein cholesteral (LDL-C) were observed.Results Compared with the control group,after treatment in the observed group,the TCM syndrome score of palpitation,fatigue and thetotal accumulated score were all obviously decreased (palpitation score:0.9 ± 0.4 vs.1.2 ± 0.8,fatigue score:1.1 ± 0.7 vs.1.7 ± 0.8,total accumulated score:4.8 ± 1.2 vs.8.1 ± 1.8,all P ＜ 0.05);the LVEDV,the serum levels of HbA1c,Ang Ⅱ and BNP were also obviously decreased in the observed group [LVEDV (mL):136.28 ± 17.52 vs.158.82 ± 19.03,HbA1c (％):6.11±0.36 vs.6.89 ±0.32,Ang Ⅱ (ng/L):66.48 ± 17.64 vs.84.55 ± 20.39,BNP (μg/L):138.45 ± 87.55 vs.219.14±88.83,all P ＜ 0.05];The 6MWD,LVEF,SV,CO and E/A were all increased plainly in the observed group [6MWD (m):470.47 ± 79.66 vs.428.46 ± 88.56,LVEF:0.51 ±0.05 vs.0.46 ± 0.04,SV (mL):55.36 ± 2.88 vs.50.32±2.76,CO (L/min):5.74±0.91 vs.4.92±0.74,E/A:1.18±0.27 vs.0.83±0.28,all P ＜ 0.05].The degrees of decreased levels in TC,TG,LDL-C and the degrees of increased levels of HDL-C in observed group were superior to those of the control group,but there were no statistical significant differences (all P ＞ 0.05).Conclusion JTSXD shows good therapeutic effect and safety for treatment of diabetic patients accompanied by CHF (NYHA functional class Ⅱ-Ⅲ),and its mechanisms may be related to its regulation of glucose (reduction of HbA1c level),correction of lipid metabolism disorders,improvement of myocardial energy supply,inhibition of the activation of renin-angiotensin-aldosterone system (RAAS) and the secretion of BNP.

Objective To investigate the short-term efficacy of compound gargle solution chlorhexidine giuconatie and kangfuxin liquid in treatment of recurrent aphthous ulcer (RAU).Methods Eighty patients clinically diagnosed with RAU were chosen and randomly divided into two groups.Test group 1 (40 cases) and Test group 2 (40 cases) were treated with compound gargle solution chlorhexidine giuconatie and kangfuxin liquid respectively until ulcer has been healed completely to evaluate the difference of two groups in clinical efficacy.Return visit and follow-up visit were conducted 7 days and 30 days after the initial treatment,respectively.Results The analgesic onset time of Test group 1 [(6.24 ± 1.09) min] was shorter than that of Test group 2 [(8.62 ± 1.04) min],with statistically significant difference (P ＜ 0.01).The analgesic maintenance time of Test group 1 [(29.47 ± 3.45) min] was longer than that of Test group 2 [(21.61 ±2.18) min],with statistically significant difference (all P ＜ 0.01).The duration of ulcer of Test groups 1 and 2 was (5.97-± 0.87)days and (4.76 ± 1.14)days,with statistically significant difference (P ＜0.01).Conclusions Compound gargle solution chlorhexidine giuconatie and kangfuxin liquid both have a certain level of clinical efficacy for RAU,with the former featuring shorter analgesic onset time and longer duration and the latter advantageous in promoting RAU healing short-term usage of compound gargle solution chlorhexidine giuconatie and kangfuxin liquid cannot prolong RAU dormancy.

PURPOSETo explore the impact of subtropical maritime monsoon climate on the frequency of ambulance use for trauma patients in a coastal region in China.

METHODStatistical analysis of data on ambulance use from the 120 Emergency Command Center in Shantou City, Guangdong Province, from January to December 2012 as well as daily meteorological data from a Shantou observatory was performed to determine how climatic factors (seasons, time, and weather) affect the frequency of ambulance use for trauma patients.

RESULTSThe daily ambulance use for trauma patients differed between spring and summer or autumn (p<0.05), between sunny and rainy days (p<0.05), and between cloudy and lightly or moderately rainy days (p<0.05).We found a linear correlation between daily maximum temperature and daily ambulance use for trauma patients (R² =0.103, p<0.05). In addition, there was significant difference in ambulance use between good and bad weather (p<0.05).

CONCLUSIONFrequency of ambulance use for trauma patients is affected by the subtropical maritime monsoon climate in the coastal region. Better weather contributes to increased daily frequency of ambulance use, which is the highest in autumn and lowest in spring.